If your baby always seems to have a watery eye or a bit of crusting or discharge, a blocked tear duct may be the reason.
It is one of the most common eye problems in babies, and the good news is that it usually gets better on its own.
What is a blocked tear duct?
Tears are made all the time to keep the eyes moist and healthy.
Normally they drain away through a tiny tube—the tear duct, also called the nasolacrimal duct—that runs from the inner corner of the eye down into the nose.
This is why your nose runs when you cry.
In many newborns, the lower end of this tube has not fully opened yet. A thin bit of tissue—a membrane called the valve of Hasner—blocks the drainage.
Tears then back up and spill over onto the cheek instead of draining.
Doctors call this congenital nasolacrimal duct obstruction.
“Congenital” simply means present from birth.
How common is it?
Blocked tear ducts affect more than 1 in 20 babies, and some studies report even higher rates.
The blockage can affect one eye or both.
What are the signs?
Symptoms often start at birth or during the first few weeks of life.
You may notice:
- A watery eye, with tears pooling or spilling onto the cheek even when your baby is not crying
- Mucus or yellowish discharge in the corner of the eye
- Crusting on the eyelids and lashes, especially after sleep
- Mild redness or irritation of the eyelid skin from constant wetness
Importantly, the white of the eye itself usually stays clear, and your baby is generally comfortable and not in pain.
An uncomplicated blocked tear duct usually does not affect your baby's vision.
How is it diagnosed?
A doctor can usually diagnose a blocked tear duct based on the history and an examination of the eyes.
Sometimes a simple, painless test is used: a drop of colored fluorescein dye is placed in the eye, and the doctor checks a few minutes later to see whether it drains normally or remains on the surface.
The doctor will also make sure the tearing is not caused by another problem, such as an eyelash rubbing the eye or other eye irritation.
Rarely, persistent tearing—especially when accompanied by significant sensitivity to light, a cloudy-looking cornea, or an unusually large-looking eye—can be a sign of childhood glaucoma and needs prompt medical evaluation.
Will it go away on its own?
Most likely, yes.
About 9 out of 10 blocked tear ducts open on their own by the time a baby is 1 year old.
Because spontaneous improvement is so common, the first approach is usually watchful waiting combined with simple home care.
Home care
Tear duct massage
Tear duct massage is commonly recommended and may help the membrane open.
Using a clean finger, gently place pressure over the tear sac—the area just beside the inner corner of the eye, next to the bridge of the nose—and massage downward.
The technique matters: firm but gentle downward pressure over the tear sac is more useful than simply rubbing the skin around the eye.
Your baby's doctor can show you exactly where to massage and how often to do it.
Keeping the eye clean
Wipe away crusting and discharge with a cotton pad or clean cloth moistened with warm water.
Wipe gently from the inner corner of the eye outward.
Antibiotic drops or ointment
Antibiotic eye drops or ointment are sometimes prescribed when there is significant yellow-green discharge or crusting.
They can help control bacterial overgrowth and discharge, but they do not open the blocked tear duct.
Long-term antibiotic use is generally avoided.
What if it doesn't clear up?
If the blockage is still causing symptoms after the first year of life, or sooner if problems are severe, your doctor may refer your child to an eye specialist called an ophthalmologist.
Options include:
- Probing: A very thin, smooth instrument is passed through the tear duct to open the blocked membrane. It is a quick procedure, usually done under a brief general anesthetic in young children, and is successful in the large majority of cases.
- Other procedures: For the small number of tear ducts that remain blocked, options may include balloon widening of the duct, placing a temporary tube or stent, or, rarely, a more involved procedure to create a new drainage pathway.
Your specialist will help you decide on the best timing and approach for your child.
There is no single “right” time to intervene, and this is a reasonable decision to discuss together.
When to call the doctor promptly
Seek medical attention promptly if you notice:
- A red, tender, swollen lump at the inner corner of the eye near the nose
- Spreading redness or swelling around the eye or eyelid
- Fever or a baby who seems unwell or unusually fussy
- Increasing thick discharge accompanied by swelling
These symptoms can indicate an infection of the tear sac called dacryocystitis, which needs medical treatment.
A firm bluish swelling at the inner corner of the eye that is present from birth—a dacryocystocele—should also be evaluated promptly.
In some newborns, this can become infected or extend into the nose and interfere with breathing.
The bottom line
A blocked tear duct is common in babies and usually opens on its own during the first year of life.
Gentle tear duct massage and keeping the eye clean are the main things parents can do at home.
Antibiotic drops may sometimes help significant discharge, but they do not fix the underlying blockage.
If symptoms persist, an eye specialist can offer highly effective treatments.
Seek medical care sooner if the eye becomes significantly swollen or red, your baby appears ill, or you notice other unusual eye findings.